Once upon a time, a strange breed of people called ‘systematic reviewers’ used to shut themselves away in dark places, work very hard and for a long time, and eventually slide underneath their door their mysterious product, a shiny new systematic review. This would be taken and stored very carefully, and very secretly, in a document (let’s call it a scientific journal) which could only be seen and understood by those with enough gold to pass through the paywall and who knew the meaning of the special and secret words used in it. Which was all rather a shame as the contents were often quite precious and could be very useful to large numbers of ordinary people. For anyone wanting a neat graphic showing what a systematic review is, I recommend you click here. For those wanting elephants, you’ll have to wait a bit longer.

This rather miserable situation is changing. More than a year ago, at the UK Cochrane Centre, we embarked on a mission to encourage people to engage with evidence and especially to share Cochrane reviews with, well, everyone, as we’re all potential or current patients. We have lots of good stuff to share with those who plan, purchase or provide healthcare and especially here in the UK. We are also interested in engaging with people beyond the UK’s shores, something to which digital technology perfectly lends itself, of course. It’s been a year since we dusted off our dormant Twitter account, revamped our website and jumped into the world of social media with both feet.

At this point, I was going to take you through the nitty gritty of how we share Cochrane reviews now; the meetings to look at what’s new and why it might be important, the blogging and tweeting, the posting on Facebook and LinkedIn. Don’t get me wrong, this is great and I’m delighted to be sharing around sixty reviews a month in this way. But the bit that really excites me is the stuff I’m hearing, the conversations I’m having and the beautiful unfolding of how evidence is taken up and used (or not!), considered and criticized. Here are some of the things I’ve discovered in this first year of using social media and that I think are important.

Listening is vital

Edward Hopper ‘Nighthawks’

Novelist Paulo Coelho has it right. “Twitter is my bar. I sit at the counter and listen to the conversations, starting others, feeling the atmosphere.” Yes! This is quite so, though I would add to this ‘joining in conversations’. It’s no good just rushing in there and shoving your latest, favourite bit of evidence in everyone’s faces. I do a lot of listening on Twitter, hearing what people are talking about. Existing conversations can be great entry points for introducing a Cochrane review, say, on a topic being discussed and while you’re at it adding value; being useful is a great thing and one that’s likely to gain you some new followers as well as encourage the existing ones to stick with you. People thinking about using Twitter for the first time often express concerns about information overload, but it’s a far cry from having your email inbox filling up with messages demanding your attention, for you can dip in and out as suits, reading as much or as little as you want. It’s a good idea to keep an eye on tweets mentioning you, but being able to see these in a separate stream makes this easy.

Sometimes you’ve got to talk about elephants

This may not appear in many social media guides but it’s in mine and it follows on from listening. If you’re going to engage with people, you’ve got to go to where they are and talk about, or show them, things they are likely to be interested in and in ways which are accessible and appealing. Frankly, sometimes you have to talk about elephants (handy for us that the Cochrane Stroke Group inhabits the same space as two, in the wonderful anatomical museum in the University of Edinburgh). Many, many people will neither have heard of Cochrane nor care about it, so it’s no good us thinking that’s the magic word that opens every door. But we all, I think, respond to a story, to images, to shared human experiences and concerns.

I was interested to see the debate between some science communicators on Twitter yesterday about whether it was okay to use the birth of the Royal Baby as a hook to bring people to other things they probably wouldn’t have seen otherwise. Whilst I accept that it may confuse or even alienate some (and who expects everything that they click on to be just what they need, want or like?), I think this is a thoroughly good thing to do. We have good evidence, for example, that continuous support through labour has a number of benefits for mums and their babies. I want as many people as possible to hear about that and the baby story was an opportunity to get it to an audience including many who would not come looking for Cochrane but for whom this evidence is highly relevant. And so, to the general public.

‘The general public’ is a mythical beast

You can keep looking for ‘the general public’ but it doesn’t exist!

It doesn’t exist. Thank you, Alex Brown, for ending my confusion on that one, or at least explaining so clearly what of course I knew. On writing for a general audience, he asks “which one?” and points out that ‘non-specialist’ isn’t helpful either, as there are lots of ways not to be a specialist in a topic. You can hear more from Alex on this in his SciLogs blog ‘The general public is like a misused apostrophe’ (and I see he sneaked an elephant into an earlier post too!). Having decided that we would write these blogs mostly for ‘the general public’, we immediately hit the reality that this is an enormous and varied audience and to regard medical terms as the preserve of health professionals while the rest of us sit outside our caves mumbling about ‘heart attacks’ and ‘piles’, is a long way from reality. We also know that some people, and not just doctors and statisticians, really want to see those tricksy little numbers that tell them how confident we can be about a review’s findings.

For now, we’re mostly leaving out the stats, but we’re thinking about a way of letting you reveal them if you wish to. We’re making sure we say something about the quality of the evidence; this is so important to know yet can be hard to find out. We’re also trying to write clearly. It was also through Alex that I discovered Up-Goer Five, which has kept scientists busy recently, attempting to explain their hard ideas using only the ‘ten hundred’ most common words in English, which is what this web-based text-editor permits. We’ve had fun, alongside our game Social Media Roadshow participants, having a go at writing about Cochrane reviews in Up-Goer Five, which certainly made us think hard about the language we use, but sometimes resulted in having to use more complicated phrases to avoid using a ‘banned’ word that we all felt would be widely understood.

What do you think?

There seem to be things to learn every day – new technology to explore, ways of improving how we communicate, discovering what encourages people to engage and what falls flat. It’s scary, it’s exciting and we’re convinced it’s worth doing. It would be great to hear what you think. What do you find engaging or off-putting? What are your social media successes or discoveries? Do tell us!

We’ll be talking more about engaging through social media at the Cochrane Colloquium in Quebec this September and will have a poster linking to this blog. We’ll link to the poster here so watch this space!

Links:

Alex Brown Do you Speak Science? blogs at SciLogs ‘The general public is like a misused apostrophe’ 13 June 2013; ‘Why do kidneys need cells?’ 21 April 2013.

About Sarah Chapman

Sarah's work as a Knowledge Broker at Cochrane UK focuses on disseminating Cochrane evidence through social media, including Evidently Cochrane blogs, blogshots and the ‘Evidence for Everyday’ series for nurses, midwives, allied health professionals and patients.
A former registered general nurse, Sarah has a particular interest making evidence accessible and useful to practitioners and to others making decisions about health. Before joining Cochrane, Sarah also worked on systematic reviews for the University of Oxford and the Royal College of Nursing Institute, and obtained degrees in History from the University of Oxford and in the history of women’s health and illness in early modern England (MPhil., University of Reading).

I stopped there. Quite a challenge to explain what Cochrane does, why it’s important/critical to health care, etc. when the core terms are all outlawed. Would be interesting if there were a tool to evaluate Cochrane PLSs in this way. But, it would have to be a bit more permissive!

I completely agree re: listening on Twitter. The circles I frequent in the twitterverse are mostly tech and knowledge management ones but more and more I follow and am drawn into health and evidence discussions, inevitably. Keep up the good work you’re doing there! I look forward to the next #cochranesm chat.

Thanks for your comments Chris. Yes the jargon of systematic reviews, randomized trials and Cochrane are all outlawed in Up-Goer Five but I think we have no choice but to use these. However, depending on where and for whom (that knotty problem of audience again!) we’re writing there terms may need explaining the first time.I had much more difficulty trying to find an alternative to boiled or distilled water, when trying to write about the water for wound cleaning review as an exercise in our roadshow. “Water which has had things done to it to take away any bad bits” doesn’t quite do the job I felt! There are some great blogs around on the experiences of people from different disciplines trying it out; like this one http://blogs.scientificamerican.com/guest-blog/2013/01/27/science-in-ten-hundred-words-the-up-goer-five-challenge

Splasho, the producers of Up-Goer Five have come to our rescue a bit, I’ve just discovered, with Up-Goer Six, which doesn’t ban words but colour codes them according to frequency of use. I can’t wait to try it! http://splasho.com/upgoer6/

I’ll miss the next #cochranesm tweetchat but Holly will be there, Friday 2nd August at 1100 BST

We having been getting the everyone who has been attending our social media roadshows to try and write the PLSs into Upgoer 5… there have been some very funny attempts at re-writing them :-) But, yes if there could be a more inclusive tool for the PLS section that could be really useful.

I’m relatively new to Twitter, well more accurately new to tweeting. I’ve had a personal Twitter account for a while – following a number of things I’m interested in. As a result of following these things, I also get tweets from a whole range of ‘related’ Tweeters who think I may be interested in their products/organisations/opinions. I started to realise that the great thing about Twitter is that you can ignore them, or you can take in what they are saying – and then ignore them!!! It makes it so much better than people-watching in a bar – because you get to watch/listen but you don’t have to engage with anyone who you suspect may be crazy.

So onto tweeting – I only recently saw the point – or rather, I’ve only recently realised that I have something to say and a potential audience. Sarah and Holly really got that across well at the Social Media Roadshow. As an information specialist, the whole dissemination thing a really struck a chord with me – we have the Cochrane Library and all these other related products – does everyone know about them, do they understand Evidence-based medicine, do they know how to find it? Does everyone have the time/ability/inclination to log in and search The Cochrane Library every day/month to see what’s new that is important to them?

So we (the Cochrane Pregnancy and Childbirth Group – mostly me to start with but others are getting into it now) started nervously tweeting about our reviews; and we are gathering a nice number of followers – many of whom are not Cochrane Contributors, which is great as far as I’m concerned…

.. but then I battled a little with the mixed audience, the who wants to know what, how do they want to know, when do they want to know – but its Social Media – it’s not a professional forum where everything has to be sterile and utterly sensible. We go back to my first point – if the tweet is not for you, then ignore it, if you follow a link that’s not what you expected, it’s not the end of the world.

#Royalbaby – seemed a lovely timely totally pregnancy and childbirth related event – a time when the media and general public talking about babies and labour and where and how the birth would happen – should we have used it to try and get some #CochraneEvidence out there? Yes – why not? We didn’t tweet anything offensive or controversial, just pregnancy and childbirth related evidence. And yippee – it generated discussion; and it got us a few extra followers and retweets – result as far I can see.

Looking forward to trying to measure the impact of Social Media in general on dissemination of evidence – early days for us at PCG but it will be really interesting to see how much further we can spread the word (and if the use of elephants or badgers or famous babies helps or hinders!)

Thank you for taking the trouble to post these reflections on your experiences so far Lynn – you make a lot of good points, which are really helpful. I hope others who are contemplating dipping a toe in the waters of Twitter will read this and feel encouraged. I think there’s a lot of nervousness out there but, as you are finding, so much to be gained by using social media to share evidence. It certainly gets it to audiences that would never encounter an academic journal, or the Cochrane Library!
Keep up the good work!
Sarah

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